Admin America: Employee Claim Forms Catalog

Admin America

DOWNLOAD HRA CLAIM FOR REIMBURSEMENT FORM

Instructions

You have two options for saving and/or completing the claim forms.

1) Print copies of the blank form without saving it on your computer.

2) Save the blank form to your computer for later access and close out of the web site.

1) Print copies of the blank form without saving it on your computer.

1) Open the HRA Claim For Reimbursement Form.

2) Click on the print icon. (You may print as many copies as you need.)

3.) Write information on the form before submission.

[ Go to the forms ]

[ Return to Instructions ]

2) Save the blank form to your computer for later access offline. (You will be able to access the form later and type information directly into the boxes from your computer without returning to the web.)

Please note that you will not be able to save a copy of the completed form on your computer. If you would like a copy of the typed form for your records, you will need to print it before closing the form on your screen.

1) Right mouse click on the link to the HRA Simple Plan Application

2) Save the form to your computer by selecting “Save as” or “Save Target as” depending on which browser version you have. (You will need to remember where the file is being saved.)

3) Open the file in Adobe Acrobat Reader

4) Print the form

5) Click on the print icon

[ Go to the forms ]

[ Return to Instructions ]

Form

HRA Claim For Reimbursement Form

You will need to have Adobe's Acrobat Reader, Version 6.0 or greater installed on your computer to view and print the claim forms. Click on the Adobe "Get Acrobat Reader" icon to the left to obtain the free Adobe Acrobat Reader file.

Return to the Participant Claim Forms Center

Admin America, Alpharetta, GA
Phone: (770) 992-5959 or (800) 366-2961 e-mail: info@adminamerica.com